Fill out the form below to see if you qualify.
Have you ever been diagnosed with Alzheimer’s Disease?
Have you consistently had a problem with memory or thinking?
Have you had a MRI, CT Scan of the head or lumbar puncture done?
-If yes, which one(s)?
-If yes, when (date)?
-If no, are you willing to have done if necessary?
Are you currently taking any medication for memory problems?
Do you have a caregiver or family member that is willing to accompany you to study visits and answers questions?
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